Wednesday, January 23, 2013

Older Adults With Diabetes Benefit From Self-care Programs

Authors
of an article published online in Diabetes Care say that
compared with younger adults, older adults receive equal glycemic benefit from
participating in self-management interventions. Clinicians can safely recommend
group diabetes interventions to community-dwelling older adults with poor
glycemic control, they add.

For their study, the researchers randomized 71 community-dwelling older
adults and 151 younger adults to attend a structured behavioral group, an
attention control group, or 1-to-1 education. Half of the younger group and
nearly a third of the older group had type 1 diabetes, and the rest had type 2.
All group interventions were delivered separately to patients with type 1
diabetes and those with type 2 diabetes. The researchers measured A1C,
self-care (3-day pedometer readings, blood glucose checks, and frequency of
self-care), and psychosocial factors (quality of life, diabetes distress,
frustration with self-care, depression, self-efficacy, and coping styles) at
baseline and 3, 6, and 12 months postintervention.

Both older and younger adults had improved A1C equally over time. Older and
younger adults in the group conditions improved more and maintained
improvements at 12 months. Furthermore, the authors say, frequency of
self-care, glucose checks, depressive symptoms, quality of life, distress,
frustration with self-care, self-efficacy, and emotional coping improved in
older and younger participants at follow-up.

"Many clinicians are reluctant to refer older patients to group
education, feeling that older people may require individual attention in order
to benefit," study coauthor Katie Weinger, EdD, told Medscape Medical News. She notes
that the new study answers research questions posed in a recent consensus statement from the American Diabetes Association and the American
Geriatrics Society regarding which education approaches work best for older
people with diabetes. "Our paper addresses these issues by including both
middle-aged and older adults," Weinger says.